Provider Demographics
NPI:1285903971
Name:CENTRE POINTE HEALTH - PSYCHOLOGICAL SERVICES
Entity type:Organization
Organization Name:CENTRE POINTE HEALTH - PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHERIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:JOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-735-7112
Mailing Address - Street 1:3920 PLANK RD
Mailing Address - Street 2:120
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-7104
Mailing Address - Country:US
Mailing Address - Phone:540-446-0327
Mailing Address - Fax:540-786-2396
Practice Address - Street 1:3920 PLANK RD
Practice Address - Street 2:120
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407-7104
Practice Address - Country:US
Practice Address - Phone:540-446-0327
Practice Address - Fax:540-786-2396
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-25
Last Update Date:2011-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty